Evaluating the Timing of Sitz Baths After Laser Hemorrhoidoplasty: An Exploratory Study.

BACKGROUND: Laser hemorrhoidoplasty (LHP) is a minimally invasive procedure for the treatment of hemorrhoids. Early sitz baths are recommended after conventional hemorrhoidectomy; however, their effectiveness following LHP has not been evaluated. AIM: This study aimed to evaluate the timing of sitz baths for postoperative recovery in patients undergoing LHP. METHODS: A retrospective analysis was conducted on patients with grade I-IV hemorrhoids who underwent LHP between March 2023 and December 2025. Patients were grouped by sitz bath timing: operation day, postoperative day 1, or after discharge. Primary outcomes were maximum and mean visual analog scale (VAS) pain scores and change in VAS scores (ΔVAS) between operation day and postoperative day 1. Secondary outcomes included intraoperative parameters, recovery outcomes, and complications (urinary retention and bleeding). RESULTS: Of 310 patients, 92 began sitz baths on operation day, 146 on postoperative day 1, and 72 after discharge. Mean initiation times were 6.6 and 21.0 h for the operation-day and postoperative-day-1 groups (p < 0.0001). The operation-day group had significantly higher mean VAS pain score (1.31 ± 0.77 vs. 0.91 ± 0.57 vs. 0.93 ± 0.6, p = 0.0022) on the operation day and △VAS pain score (mean) (-0.27 ± 0.67 vs. 0.12 ± 0.63 vs. 0.14 ± 0.56, p = 0.0018) compared with other groups. Complication rates did not differ among groups. Multivariable analysis showed that delayed sitz bath was independently associated with lower mean VAS pain score on postoperative Day 1 (β = -0.374, 95% CI: -0.551 to -0.196, p < 0.001) and after discharge (β = -0.364, 95% CI: -0.572 to -0.156, p < 0.001). CONCLUSIONS: Although this study failed to show advantages of early sitz baths, it does not exclude potential benefits for sitz baths after LHP. Prospective studies with larger cohorts are warranted.